Top 5 Symptoms of Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal imbalance that affects many women of childbearing age. It is a common condition, affecting roughly 1 in 10 women, and can cause a variety of symptoms. While PCOS presents differently for everyone, there are some key signs to watch out for.

STEP: Heart Failure in Obesity & Diabetes

Semaglutide benefits obesity-related heart failure in type 2 diabetes, improving symptoms and aiding weight loss. The STEP trial evaluated the effects of semaglutide (Ozempic or Wegovy) 2.4 mg weekly in participants with heart failure, obesity, and type 2 diabetes. Patients received either semaglutide or placebo for 52 weeks.

SELECT: Obesity & Heart Health

Semaglutide, marketed as Ozempic or Wegovy and administered at a weekly dosage of 2.4 mg, has demonstrated a noteworthy reduction in cardiovascular events by 20% among non-diabetic individuals with obesity. Most participants had a diagnosis of prediabetes and a history of either myocardial infarction (MI) or stroke at the beginning of the study.

What is Insulin Resistance?

Insulin resistance is a condition in which the body’s cells become less responsive to the effects of insulin, a hormone produced by the beta cells in the pancreas. Insulin is central for regulating blood sugar (glucose) levels, facilitating the uptake of glucose by cells for energy.

What is Metabolic Syndrome?

Metabolic syndrome is a cluster of conditions that occur together, increasing the risk of heart disease, NASH, and type 2 diabetes. The precise medical definition and diagnostic criteria may vary slightly among different organizations, but a widely accepted definition is provided by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III).

Supervised Weight Loss in Maryland

Struggling with obesity can present a challenging and complex journey. If you find yourself seeking effective and personalized assistance to address your weight loss concerns, collaborating with a board-certified obesity specialist might be the solution you’ve been searching for.

Mounjaro Injection for Weight Loss

Obesity significantly impacts a substantial portion of the population in the United States, making it a widespread and pressing health concern. Present statistics indicate that approximately 42% of Americans meet the criteria of having a body mass index (BMI) of 30 or higher, categorizing them as obese.

From obesity and triglycerides to pancreatitis

Obesity rates are rising worldwide. Acute pancreatitis is also on the rise. The authors of the current study followed prospectively about 120,000 individuals. As expected, they found a high correlation between BMI and acute pancreatitis events. Investigators also observed that hypertriglyceridemia could explain about 22-30% of the relationship between obesity and pancreatitis.

The results of the study, although not new, confirm prior research and knowledge that obesity leads to insulin resistance, which in turn elevates blood triglyceride concentration. Hypertriglyceridemia is a well-known specific cause of acute pancreatitis, especially when triglyceride measurements are above 500 mg/dL.

Clinically, it is essential to screen obesity patients for hypertriglyceridemia. A fasting lipid panel is a simple and inexpensive laboratory test that can provide significant insights into the patient’s risk of insulin resistance and pancreatitis.

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Intensive weight loss eliminates type 2 diabetes

Type 2 diabetes has traditionally been perceived as a non-reversible, progressive condition that eventually requires insulin therapy. Recent evidence, however, has been mounting in showing that type 2 diabetes, if diagnosed early, can be fully reversed with intense lifestyle modifications in a subset of patients.

In the current study published in Diabetic Medicine in September 2019, investigators followed prospectively about 900 adult diabetes patients age 40-70 over five years. Individuals who lost more than 10% of body weight within the first few years of the study, had the best chance of eliminating diabetes, as documented by A1c <6.5%.

At the study conclusion, 30% of adults achieved diabetes remission. Important to note that remission or reversal was accomplished independently of any specific lifestyle modifications, except the >10% weight loss.

More clinical trials are needed to confirm the above results. Nonetheless, intensive weight loss at the onset of diabetes diagnosis could be reasonable general advice for people who are overweight or obese.

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New FDA approval: semaglutide, the first oral GLP-1 agonist for type 2 diabetes

The FDA has now approved the first oral semaglutide, Rybelsus, for the treatment of type 2 diabetes. This approval marks a breakthrough advancement in the field of clinical diabetology. Rybelsus is the first “protein” based molecule to be administered orally and not subcutaneously via an injection.

Oral administration of semaglutide is made possible through the use of SNAC compound. SNAC helps escort and transport the semaglutide intact across the gastrointestinal epithelial cells. It assists in bypassing the harsh acidic environment of the stomach.

Various clinical trials, under the name PIONEER, have consistently shown A1c improvements and weight loss benefits with Rybelsus – thus leading to this landmark FDA acceptance.

Rybelsus comes at three doses; 3, 7, and 14 milligrams. Patients should start at 3 mg per day for one month before advancing to the 7 mg, and if needed, to the 14 mg daily dosage. Rybelsus should be taken in an empty stomach, with no more than 4 ounces of plain water, and at least 30 minutes before breakfast.

Similar to other GLP-1 agonists, oral semaglutide can cause gastrointestinal side effects like nausea and diarrhea. Providers should be cautious when prescribing Rybelsus in those with a predisposed risk for pancreatitis, diabetic retinopathy, or kidney injury. It should not be prescribed in people with a personal or family history of medullary thyroid carcinoma.

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Primary hyperaldosteronism in obesity

In this retrospective study, investigators analyzed a group of 400 adults with hypertension due to primary hyperaldosteronism. The study found that obese patients had smaller aldosterone-producing tumors than lower BMI counterparts. It appears that obese individuals had more aggressive – higher functioning – tumors in spite of their smaller size. Adrenalectomy led to a similar clinical outcome – blood pressure improvement – in patients with or without high BMI. Although these results need to be confirmed, it would be useful for endocrinologists, radiologists, and surgeons to be aware of this phenotype.

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